Case Mix

BHolliRNMS · May 22, 2004

Be sure the a3a date captures all your part b therapy...may need to use grace days. Be sure therapy screens every resident that is scheduled to have an assessment done 3-4 weeks prior to the assessment period. That way, they can pick the resident up prior to the assessment. Restorative! Restorative! Restorative! for residents not in therapy. Also, be sure the assessment nurses are capturing the adl performance correctly. Most nurses code residents more independant than they actually are...they must consider the resident's performance across all shifts. Also check that you are capturing behaviors.

FrazzledRN · May 31, 2004

Hi!

Alot of it is setting an appropriate date...and capturing those MD visits and orders, oxygen, aerosols, IV's, etc..! I get the nurses 24 hour report sheets daily, lists from our SS dept on when the dentists, eye doc, etc.. visits and the residents that have been seen...etc. Then go to the charts and see who I can pick up to do and what I can capture. Then set the dates accordingly. Definitely ensure accurately coding those ADL scores and behaviors! I keep track of the lowest RUG score residents and look for ways to boost these up. Borderline reports, etc. We have a software program called "Casemix Coach" that provides alot of ideas after the assessment is done and inputted to the program before submission to State.

Watch discharges and admissions at the end of the quarter...if you have a high RUG resident who is to be discharged home and they can wait until the first of the month then wait-if appropriate of course (for example if someone is going home on the 31st and it can wait until the first then wait if appropriate for them)...capture that higher rug score....and vice versa if you have a lower score and they are planning for discharge then try to plan it before the end of the quarter so you don't capture their low score. Just some things we try...hope it helps!! :)